a major determinant of population health. The file of Health in action n°459, March 2022.

Along with housing, the socio-economic situation, living conditions, pollution and exposure to nuisances, town planning is a major but largely underestimated determinant of the health of populations. Inappropriate or harmful town planning damages the health of the inhabitants who live there; but solutions exist, such as “healthy urbanism”, a concept that is developing.

Healthy urban planning: encouraging choices that minimize people’s exposure to risk factors

Health-friendly town planning aims to systematically take into account the consequences of any town planning and development project on the quality of life, well-being and the environment. This involves encouraging choices that minimize the exposure of populations to risk factors such as air pollution, noise pollution, social isolation, etc., and maximize their exposure to risk factors. protection such as the practice of physical activity via active mobility (non-motorized travel such as walking or cycling), access to healthcare or green spaces, etc. ; all with a view to reducing social and territorial inequalities in health.

Seven years after the publication of a dossier devoted to urban planning and developments favorable to health, this new issue of La Santé en action bears witness to the advances and margins of progress in this field. The context has evolved: climate change and its repercussions on the physical and mental health and on the quality of life of populations are increasingly known and visible. Recognition of the complex interrelationships between human health, animal health, environmental health and ecosystems has led to the rise of three concepts promoted by the WHO: “health in all policies”, “planetary health” and “one health”. These approaches are gradually being integrated into public policies, for example in France in the 4th National Environmental Health Plan.

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Healthy urban planning: state of knowledge

The “State of knowledge” part of the dossier places the subject of health-friendly town planning within these developments and recalls the synergies between public health actions, approaches to the protection of the environment and biodiversity, combating and adapting to climate change. Advances in recent years have thus shown that urban planning favorable to health offers a framework for understanding and grasping the interrelationships between development, health determinants, state of health and the environment, and social and territorial inequalities in health. , in a “complex system” logic.

Urban planning favorable to health is now being applied in an encouraging and increasingly widespread manner, with several feedbacks. The examples reported testify to the need for a shared culture between public health actors and planning actors, but also to the overall dynamics at work.

Urban planning favorable to health: the emblematic case of cities, particularly vulnerable to the climate challenge…

Several articles are devoted to health in urban areas, where 55% of the world’s population live, a proportion that is expected to increase to 68% by 2050. Cities are particularly vulnerable to climate risks (extreme events, systemic crisis) and environmental (air pollution, heat wave, noise, etc.).

…but there are solutions

Faced with this situation, there are accessible and effective strategies, favorable in terms of climate, biodiversity and public health. Local authorities can act provided they develop a strong desire for multi-sector collaboration. For elected officials, municipal technical departments and other stakeholders in regional planning, a priority should be to set up organizations and ad hoc decision-making processes. These must make it possible to deal in a concerted manner with the issues of adaptation to climate change, protection of biodiversity and public health, and to propose solutions adapted to the local context, creative and based on evidence.

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Some examples of local actions implemented

Articles relate the experience of the Urban Community of Dunkirk, which has made public transport free, of Miramas, which is demolishing and rebuilding a popular district with its eyes riveted on air quality, access to healthcare and social services, social cohesion and physical activity/nutrition, but also other similar approaches in Rennes, Grenoble, Echirolles, Villeurbanne, Besançon, as well as in Lyon and Toulouse with the testimony of town planners and researchers.

Examples of actions implemented abroad

This file also highlights the experience of five cities abroad on the issue of urban planning favorable to health: Glasgow (Scotland), La Chaux-de-Fonds (Switzerland), Pontevedra (Spain), Lathi ( Finland) and Sherbrooke (Quebec).

In all, some twenty researchers and professionals in the field have contributed to this issue, including the World Health Organization, and which shows how cities such as Lima (Peru), Freetown (Sierra Leone) have taken up the issue of urban planning as a determining factor of social and territorial inequalities in health.

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